Electronic Health Object: Transforming Health Care Systems From Static to Interactive and Extensible

Health managers and community representatives' views of a system-wide intervention to strengthen public healthcare in the Free State, South Africa

Background

A system-wide health system strengthening (HSS) initiative, the Health Systems Governance and Accountability (HSGA) intervention, was developed, translated to policy, and implemented in the Free State province. This study assessed health managers (HMs) and community representatives' (CRs) views of the intervention and whether it improved integration and performance.

Method

A questionnaire survey among 147 HMs and 78 CRs and 14 focus group discussions (FGDs) with a mean of 10.3 participants and a total of 102 HMs and 42 CRs, were conducted. The questionnaire and FGD data were descriptively and thematically analysed to triangulate findings.

Results

Many HMs (44%) mostly positioned at the operational levels indicated that implementation of the HSGA intervention did contribute to integration of health services. Most CRs (54%) believed that communities were actively involved in the intervention. However, both the self-administered questionnaire and the FGD data evidenced lack of policy awareness among, especially, operational-level HMs.

Conclusion

From the perspectives of HMs and CRs, the implementation of the intervention was viewed as a step forward in strengthening public healthcare to respond to system deficiencies in the Free State province. Earlier engagement of especially operational-level HMs during reforms may be beneficial in successfully implementing HSS interventions.

A strengths-based data capture model: mining data-driven and person-centered health assets

With health care policy directives advancing value-based care, risk assessments and management have permeated health care discourse. The conventional problem-based infrastructure defines what data are employed to build this discourse and how it unfolds. Such a health care model tends to bias data for risk assessment and risk management toward problems and does not capture data about health assets or strengths. The purpose of this article is to explore and illustrate the incorporation of a strengths-based data capture model into risk assessment and management by harnessing data-driven and person-centered health assets using the Omaha System. This strengths-based data capture model encourages and enables use of whole-person data including strengths at the individual level and, in aggregate, at the population level. When aggregated, such data may be used for the development of strengths-based population health metrics that will promote evaluation of data-driven and person-centered care, outcomes, and value.